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Path - Histopath > skin pathology > Flashcards

skin pathology Flashcards

1
Q

describe the layers of skin?

A

in order:

epidermis
dermis
subcutaneous fat
supportive matrix composed of collagen and elastic fibres

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2
Q

in which layer of skin do you have;

blood vessels, sweat glands, hair follicles, sebaceous glands and nerve fibres

A

dermis

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3
Q

characterise Palmar-Plantar Skin?

A

no sebaceous glands

very thick corneal layer - keratin

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4
Q

what is the effect of ageing on skin?

A

skin becomes fragile and thin with thinner epidermis

The collagen and elastic fibres are also of poor quality

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5
Q

list the Inflammatory Reaction Patterns and their meaning?

A

• Vesiculobullous - forms bullae
• Spongiotic - becomes oedematous
• Psoriasiform - becomes thickened
• Lichenoid - forms a sheeny plaque
• Vasculitic - associated with vasculitides
Granulomatous - associated with granulomas

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6
Q

characterise bullous pemphigoid?

A
  • They commonly occur in elderly patients on their flexor surfaces
    • This condition is characterised by the formation of tense bullae
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7
Q

what is the aetiology of bullous pemphigoid?

A

an autoimmune disorder driven by IgG and C3, which attack the Basement membrane

DERMO-EPIDERMAL junction

recruit eosinophils which release elastase which further damages the anchoring proteins that are anchoring the lower keratinocytes onto the basement membrane

-> house lifted off foundation (BM)

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8
Q

what is used in the detection of IgG and C3?

found where?

A

immunofloresence

DERMO-EPIDERMAL junction

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9
Q

In this condition, the blisters are much more flaccid
They rupture easily leaving this raw, red surface underneath ;

this describes which condition?

A

pemphigus vulgaris

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10
Q

what is the aetiology of pemphigus vulgaris?

A
  • This is an IgG disease
    • The damage is occurring within the keratinocyte layers (i.e. within the bricks)
    • This is called acantholysis (loss of intercellular connections leading to loss of cohesion between keratinocytes)
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11
Q

ivx for pemphigus v?

A

immunofloresence;

IgG lining the layers of KERATINOCYTES

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12
Q

characterise Pemphigus Foliaceus? aetiology?

A

• You rarely see the intact bullae in this condition because they are so thin that they come off easily

it is the roof that is coming apart (the outer layer of keratinocytes where the stratum corneum is)
This is also IgG mediated

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13
Q

what condition is characterized by round spots of oozing or dry rash, with clear boundaries, often on lower legs.

ITCHY Flexural surfaces

It is usually worse in winter. Cause is unknown, and the condition tends to come and go.

A

discoid eczema

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14
Q

what are the subtypes of contact dermatitis?

A

Allergic
- Type 4 delayed hypersensitivity rxn (eeven though allergic reactions are usually type 1) so T cell mediated

Irritant
- touch metal, detergents etc

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15
Q

what are the mediators in the following hypersensitivity reactions;

Type 1
Type 2
Type 3
Type 4

put in order of time taken to respond. give examples

A

in order

Antibody mediated response;
Type 1 - IgE
Type 2 - IgG or IgM cytotoxic
Type 3 - immune complex mediated

Cell mediated response;
Type 4 - T cell

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16
Q

give examples of the 4 hypersensitivity reactions

A

Type 1 - anaphylaxis
Type 2 - haemolytic anaemia
Type 3 - SLE, serum sickness
Type 4 - rash

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17
Q

what occurs as a result of scratchin in contact dermatitis?

A

hyperparakeratosis

18
Q

what inflammatory reaction type is eczema?

A

spongiotic because there is fluid/oedema in between the keratinocytes

19
Q

what inflammatory reaction type is contact dermatitis?

A

spongiotic

20
Q

the following are characteristic of what?

Extensor surfaces
White/Silvery plaques
Rapid keratinocyte turnover – skin flakes off quicker than normal!
Psoriasiform pattern

A

plaque psoriasis

21
Q

recruitment of neutrophils (forming Munro’s microabscesses) in the epidermis are seen in which condition?

A

plaque psoriasis

22
Q

characterise keratinocyte turnover time in p psoriasis vs normal

A

turnover is around 7 days

vs 50 days in normal people

23
Q

which conditions exhibit a lichenoid reaction pattern?

A

lichen planus

24
Q

the following are characteristic of which condition?

presents as papules and plaques that are slightly purplish in colour on the wrists and arms

In the mouth it presents as white lines (Wickam striae)

A

lichen planus - t cell mediated

25
Q

the following is witnessed in which condition?

band-like lymphocytic infiltrate just under the epidermis

A

lichen planus
mycosis fungiodes

blurred junction between dermis and epodermis due to lymphocyte destruction

26
Q

the following is witnessed in which condition?

band-like lymphocytic infiltrate just under the epidermis

A

lichen planus
mycosis fungiodes

blurred junction between dermis and epodermis due to lymphocyte destruction

27
Q

name a derm condition with a vasculitic inflam pattern?

A

pyoderma gangrenosum

28
Q

characterise pyoderma gangrenosum?

A

• It presents as an ulcer - large and painful

This is often the first manifestation of a systemic disease (e.g. ulcerative colitis, chrons, leukaemia)

29
Q

define a granuloma?

A

Granuloma – collection of activated histiocytes (macrophages)

30
Q

characterise Seborrhoeic Keratosis?

A

entrapped keratin surrounded by a proliferating (orderly) epidermis

common in the elderly

microscope you will see horn cysts

Pigmented cauliflower

31
Q

the following is witnessed in which condition?

smooth surface
They are non-mobile and tend to have a punctum
squamous epithelium along the lining
• They can be very smelly

A

Sebaceous/Epidermal Cyst

32
Q

Rodent Ulcer is aka?

A

basal cell carcinoma

33
Q

the following is witnessed in which condition?

rolled, pearly edge with a central ulcer and telangiectasia
• It doesn’t tend to cause any significant morbidity or mortality
• However, they can be disfiguring if they form on the face

A

basal cell carcinoma

34
Q

aetiology of basal cell carcinoma?

A

arises from the keratinocytes along the bottom of the epidermis
• These cells then infiltrate through the basement membrane
• They can spread via the nerves and lymphovascular system or they can cause local infiltration

BCCs are locally infiltrative but they don’t metastasise

35
Q

Bowen’s Disease is what type of cancer?

A

squamous cell carcinoma in situ
precancerous lesion
Lots of keratin seen

36
Q

the following is witnessed in which condition?

Melanocytes expand from the basal layer and form nests

A

junctional naevus

37
Q

define pagetoid spread?

A

melanocytes are starting to migrate upwards through the epidermis - this is NOT normal

upon reaching dermis, become mitotically active and lack the ability to mature -> malignant melanoma

38
Q

melanoma with a thickness > 4 mm, has ______ mortality ?

A

a very high (> 50%)

39
Q

how is melanoma staged?

A

Breslow thickness used for malignant melanoma

DIAMETER does NOT matter in melanoma its about thickness

40
Q

what are the stages of the Hair follicle cycle?

A

the hair follicles cycle continuously from anagen to telogen returning to anagen through growth of the lower segment.

anagen -> catagen -> telogen and repeat

Path - Histopath (21 decks)

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